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冠脉CT成像血管扩张剂的规范化应用及冠脉粥样硬化斑块的随访研究的综述报告.docx

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冠脉CT成像血管扩张剂的规范化应用及冠脉粥样硬化斑块的随访研究的综述报告 Introduction Coronaryarterydisease(CAD)isamajorcauseofmorbidityandmortalityworldwide,leadingtoadversecardiovasculareventssuchasacutecoronarysyndromes,heartfailure,andsuddencardiacdeath.Coronarycomputedtomographyangiography(CCTA)hasemergedasanon-invasiveimagingmodalityforthedetectionofCAD.TheuseofCTcontrastagentsforcoronaryarteryimaginghasimprovedtheaccuracyandsensitivityofCCTA,leadingtobetteridentificationofcoronaryarterystenosisandplaqueburden.ThisreportsummarizesthestandardizeduseofCTcontrastagentsforcoronaryarteryimagingandthefollow-upstudiesforcoronaryarteryplaques. StandardizationofCTContrastAgentAdministration TheadministrationofCTcontrastagentsiscrucialforobtaininghigh-qualityCCTAimages.TheAmericanCollegeofRadiology(ACR)hasdevelopedguidelinesfortheadministrationofCTcontrastagentstoensurestandardizationandsafetyinclinicalpractice.Theguidelinesrecommendanintravenouscontrastbolusinjectionatarateof4-5ml/sfollowedbyasalineflushof40-60mlatthesameinjectionrate.Thetotalcontrastvolumeshouldnotexceed100mlforpatientswithnormalrenalfunctionandshouldbeadjustedforpatientswithrenalimpairment. ThetimingofCTimageacquisitionaftercontrastinjectionisalsoimportantforoptimalcoronaryarteryimaging.TheACRguidelinesrecommendadelayof5-7secondsfortheimagingoftheleftventricle,10-15secondsfortheimagingoftheproximalcoronaryarteries,and20-25secondsfortheimagingofthedistalcoronaryarteries.Adual-sourceCTscannerwithatemporalresolutionoflessthan75msecisrecommendedforbetterimagequality. Follow-upStudiesforCoronaryArteryPlaques CCTAallowsfortheidentificationandcharacterizationofcoronaryarteryplaques,providingvaluableinformationforriskstratificationandmanagementofCAD.Thefollow-upofcoronaryarteryplaquesusingCCTAhasbeenshowntobeareliablemethodforevaluatingtheprogressionofatherosclerosisandtheeffectsofmedicaltherapy.Theassessmentofcoronaryarteryplaquescanbeperformedusingvariousparameters,includingplaquevolume,plaqueburden,andplaquecomposition. Severalstudieshavein